China's human resources for health: quantity, quality, and distribution.
In this paper, we analyse China's current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses-in 2005, there were 1.9 million licensed doctors and 1.4 million nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Most of China's doctors (67.2%) and nurses (97.5%) have been educated up to only junior college or secondary school level. Since 1998 there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce. Inter-county inequality in the distribution of both doctors and nurses is very high, with most of this inequality accounted for by within-province inequalities (82% or more) rather than by between-province inequalities. Urban-rural disparities in doctor and nurse density account for about a third of overall inter-county inequality. These inequalities matter greatly with respect to health outcomes across counties, provinces, and strata in China; for instance, a cross-county multiple regression analysis using data from the 2000 census shows that the density of health workers is highly significant in explaining infant mortality.
Anand
Sudhir
S
Department of Economics, University of Oxford, Oxford, UK; Global Equity Initiative, Harvard University, Cambridge, MA, USA.
Fan
Victoria Y
VY
Zhang
Junhua
J
Zhang
Lingling
L
Ke
Yang
Y
Dong
Zhe
Z
Chen
Lincoln C
LC
D002681:China; D004522:Educational Status; D005260:Female; D018166:Health Care Reform; D006282:Health Personnel / Q000193:education / Q000706:statistics & numerical data*; D006280:Health Workforce / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D019035:Rural Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution; D019037:Urban Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution